Gastric bypass for weight loss increases alcohol use, study says

A major new study confirms previous sporadic reports that weight-loss surgery increases the risk of alcohol abuse, researchers reported Monday. In the second year after having a gastric bypass, technically known as Roux-en-Y surgery, patients were 30% more likely to have problems controlling their alcohol use, a team reported online in the Journal of the American Medical Assn. and at the annual meeting of the American Society for Metabolic and Bariatric Surgery.

Previous reports have suggested that alcohol abuse could be a problem following bariatric surgery, but the studies have been small and generally involved collecting data at some point after the procedure. In the new study, a team led by epidemiologist Wendy C. King of the University of Pittsburgh School of Medicine began studying 2,458 adults before they underwent bariatric surgery at one of 10 hospitals. Of those, 1,945 could be monitored for one to two years after the procedure.

The team found that 7.6% of the patients suffered from alcohol-abuse disorders (abuse and dependence) in the year before the surgery. At the end of one year after the procedure, the percentage was about the same, 7.3%. But by the end of the second year, the prevalence of such disorders had climbed to 9.6%, a 30% increase. Virtually all of the increase occurred in patients who had undergone gastric bypass, with no increase among the roughly 30% of patients who had a banding procedure.

Some research suggests that the increase in problems arises because the metabolism of alcohol changes after gastric bypass. “Given a standardized quantity of alcohol, patients reach a higher peak alcohol level [in the bloodstream] after surgery compared with case-controls or their pre-operative levels,” the team wrote. In other words, bypass patients get drunk faster and with smaller amounts of alcohol.

The excessive drinking may be a greater problem for bariatric surgery patients because alcohol abuse can affect vitamin and mineral status and liver function, which are already potential problems for the surgery patients, King said. She urges clinicians to perform a better job of screening patients for abuse before surgery and to offer counseling to help them combat the problem.